Bernadette Cynthia Beasley, PSY. D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071006734 Issued in IL

Practice address

18141 Dixie Hwy
Suite 203
Homewood, IL 60430-2238

Phone

(708) 922-3530

Fax

(708) 922-3531

NPI assigned

Mar 22, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439164800000",
    "number": "1477512861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 COLLEGE AVE",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604431822",
            "telephone_number": "708-748-2831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18141 DIXIE HWY",
            "address_2": "SUITE 203",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302238",
            "telephone_number": "708-922-3530",
            "fax_number": "708-922-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "BERNADETTE",
        "middle_name": "CYNTHIA",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-22",
        "last_updated": "2015-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01634900",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "198803101304",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dasha Ellezian Barss, D.D.S.,M.M.SC.
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• Diane M Barton, D.C.
• Dorothy B Bassey
• Bca Consulting
• Josephine Rita Beazley, CNA
• Behavely, LLC
• Jasmaine Bell
• Bella T Prospero MD SC
• Daquan Bennett

• Clinical Psychologist in Homewood, IL
• Providers in Homewood, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.